Capitol Hill Report: Will Deficit Reduction Affect Neurology?

August 5, 2011

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Mike Amery is out of the office this week. This edition of the Capitol Hill Report is a guest post from Derek Brandt, the AAN's Congressional Affairs Representative.

What's in the Debt Deal

Last week, Congress passed a bill to avoid financial default for the first time in US history. The bill, known as the Budget Control Act of 2011, increases the debt limit by at least $2.4 trillion, eliminating the need for further debt limit increases until after the 2012 elections. The bill also reduces the deficit by $915 billion over next 10 years and establishes a bipartisan, bicameral deficit reduction committee comprised of 12 members of Congress. This joint committee is charged with producing a proposal to reduce the deficit by $1.5 trillion over 10 years. If the joint committee fails to agree on a proposal, or if their proposal is not made into law by December 23, it would set off a "trigger" that would cut $1.2 trillion automatically from federal programs across-the-board (called sequestration), including up to a 2-percent cut to physician payments. Learn more details here.

Deal Places Neurology in Triple Jeopardy

Between the looming SGR cut of 29.5 percent on January 1, 2012, future cuts called for by the Independent Payment Advisory Board (IPAB), and the potential for more reimbursement reductions in the deficit reduction committee proposal, neurology and the rest of the physician community have been placed in a situation of triple jeopardy.

The good news is that at least one congressional leader believes a permanent SGR fix could be a part of the joint deficit reduction committee proposal. On the day the Budget Control Act was signed into law, I spoke with Rep. Henry Waxman (D-CA), ranking member of the House Energy and Commerce Committee. His take was that the joint committee would either only cut enough to avoid letting the across-the-board cuts go into effect, or if they are able to find some bipartisan consensus, they may look more broadly at tax and entitlement reform. He said if that happens there is a chance a long term or permanent SGR fix could be incorporated into their proposal.

AAN members can count on the Academy to work tirelessly to prevent any cuts in Medicare payments, be it through a scheduled cut or a recommendation.

Get Involved During the August Recess

Congress will be out of session until after Labor Day, which means your members of Congress will be home in their district offices to meet with constituents, engage the local press, and be seen in their communities. Now is the time to make your case to your members of Congress.

Take advantage of this opportunity to educate your senators and representatives about the value of neurologists in their community and the significant challenges facing the profession now and in the future. If you need any assistance to set up a visit with your member of Congress, please email me at dbrandt@aan.com and I would be happy to help facilitate.

Neuroscience Caucus Meeting

Last week, a briefing was held by the co-chairs of the congressional Neuroscience Caucus, Reps. Earl Blumenauer (D-OR) and Cathy McMorris Rodgers (R-WA), along with the co-chairs of the Alzheimer's Disease Task Force, Reps. Edward Markey (D-MA) and Chris Smith (R-NJ). The session's goal was to educate congressional staffers about neuroscience research at NIH, ongoing efforts to improve coordination and collaboration among researchers, and what the implication of those efforts are for a range of conditions including Alzheimer's disease and autism.

Dr. Story Landis, Director of the National Institute of Neurological Disorders and Stroke (NINDS), was in attendance and spoke about neuroscience research initiatives at NIH. The event had a great turnout, with more than 25 congressional staffers in attendance.

Stem Cell Research Funding Maintained

Last week, District Court Judge Royce Lambeth dismissed a lawsuit that sought to ban federal funding for human embryonic stem cell research. The decision is the latest development in the case of Sherley v Sebelius—a landmark lawsuit filed against the NIH in 2009. Last year, Lambeth had issued a preliminary injunction to suspend federal funded embryonic stem cell research, but this ruling was quickly overturned by the Court of Appeals in Washington.

The District Court ruled that, based on the Court of Appeals recent ruling, the "NIH seems to have reasonably concluded that…Dickey-Wicker does not prohibit funding for a research project in which a [embryonic stem cell] will be used," and was "constrained" to adopt that opinion and rule in favor of the government.

The plaintiffs still reserve the right to appeal this ruling, but for now the ability to pursue ethical federally funded stem cell research funding has been maintained.

Pediatric Neurology GME Gains Traction

Earlier this year in his annual budget proposal, President Obama recommended terminating the Children's Hospital Graduate Medical Education payment program (CHGME) which provides more than $300 million a year to the 56 free-standing children's hospitals around the country and trains more than 40 percent of pediatric specialists, including neurologists. As a result, Sens. Robert Casey, Jr. (D-PA) and Johnny Isakson (R-GA) and Reps. Joe Pitts (R-PA) and Frank Pallone, Jr. (D-NJ), have introduced legislation to save this program. These bills have received strong bipartisan support from 22 senators and 56 representatives and have been gaining traction.

The House version of the bill was approved by the powerful House Energy and Commerce Committee, and in the Senate a hearing on this legislation has been set for September 7, which is likely the first day the Senate will be back in session after the congressional recess. The AAN will continue to monitor this issue as it moves forward.